Paraoxonase 1 enzymatic activity, a risk predictor for major adverse cardiovascular events

Abstract

Provided herein are methods for assessing the risk a subject or patient without significant evidence of cardiovascular disease has of experiencing a major adverse cardiac event or requiring revascularization near term. Also provided are methods of determining whether a subject who has experienced a major adverse cardiac event is at risk of experiencing a recurrent major adverse cardiac event near term. The present methods comprise determining the levels of paraoxonase 1 enzymatic activity in the blood, serum, plasma, or any combination of said bodily fluids in the subject.

1 - 20 . (canceled) 
     
     
         21 . A method of treating a subject identified as having a near term risk of experiencing a major adverse cardiac event comprising: performing UV spectrometry to measure the levels of paraoxanase 1 (PON1) enzymatic activity in a blood, serum, and/or plasma sample from the subject; characterizing a subject whose blood, serum, and/or plasma levels of PON1 enzymatic activity are low relative to a control or baseline value as being at risk of experiencing a major adverse cardiac event near term; and providing revascularization selected from angioplasty, stenting, and coronary artery bypass grafting intended to prevent a major adverse cardiac event to a subject characterized as being at risk. 
     
     
         22 . The method of  claim 21 , wherein the PON1 enzymatic activity is determined by measuring arylesterase activity in the test subject's blood, serum, and/or plasma sample. 
     
     
         23 . The method of  claim 21 , wherein the PON1 enzymatic activity is determined by measuring paraoxonase activity in the subject's blood, serum, and/or plasma sample 
     
     
         24 . The method of  claim 21 , wherein the PON1 enzymatic activity is determined by measuring lipolactonase activity in the subject's blood, serum, and/or plasma sample. 
     
     
         25 . The method of  claim 21 , wherein the PON1 enzymatic activity is determined by measuring lactonase activity in the subject's blood, serum, and/or plasma sample. 
     
     
         26 . The method of  claim 21 , further comprising comparing the levels of PON1 enzymatic activity in the subject's blood, serum, and/or plasma sample with a control value based on PON1 enzymatic levels in blood, serum, and/or plasma samples from the general population. 
     
     
         27 . The method of  claim 21 , further comprising comparing the levels of PON1 enzymatic activity in the subject's blood, serum, and/or plasma sample with a control value based on PON1 enzymatic levels in blood, serum, and/or plasma samples from a population of apparently healthy control subjects. 
     
     
         28 . The method of  claim 21 , further comprising comparing the levels of PON1 enzymatic activity in the subject's blood, serum, and/or plasma sample with a baseline valued derived by measuring PON1 enzymatic levels in blood, serum, and/or plasma samples from the subject at an earlier time. 
     
     
         29 . The method of  claim 21 , further comprising comparing the levels of PON1 enzymatic activity in the subject's blood, serum, and/or plasma sample with a control value based on PON1 enzymatic levels in blood, serum, and/or plasma samples from a population of subjects who exhibit no symptoms or clinical evidence of cardiovascular disease within a predetermined period of time after providing said sample. 
     
     
         30 . The method of  claim 21 , further comprising determining the Q 192 R genotype of the subject; wherein a subject having the QQ 192  phenotype is at an increased risk of experiencing a major adverse cardiac event near term. 
     
     
         31 . The method of  claim 21 , wherein the subject did not previously exhibit significant evidence of cardiovascular disease. 
     
     
         32 . The method of  claim 21 , wherein the subject has previously experienced a first major adverse cardiac event.